Every couple of days, the Obama administration highlights provisions of the new health care laws.  The latest information concerned the requirements for plans to include preventive services.  Chronic disease accounts for 75% of health care spending and many chronic diseases can be prevented.  So it makes sense to provide preventive services to not only help people lead healthier lives, but also to lower overall healthcare spending. 

The Affordable Care Act will require health plans to cover preventive services and to eliminate cost-sharing. According to a new regulation released by the Department of Health and Human Services, the Department of Treasury and the Department of Labor, people who enroll in a new health plan on or after September 23, 2010, will have insurance coverage for recommended preventive services without  a copay, co-insurance or deductible.

The current list of services was recommended by the U.S. Preventive Services Task Force (USPSTF).  For more information on services that will be provided, go to:  http://www.healthcare.gov/law/about/provisions/services/index.html

In concert with other social justice partners, NASW, on April 20, 2010 observed Equal Pay Day by calling for passage of the Paycheck Fairness Act (H.R.12/S.182).  Equal Pay Day highlights salary inequity endured by women across America and seeks to eliminate the wage gap between men and women through meaningful federal legislation.

The Paycheck Fairness Act would strengthen the 1963 Equal Pay Act and dismantle wage disparity evidenced by women who successfully perform comparable work that is occupationally equivalent to men.  This injustice and discriminatory practice is a continuing threat to the welfare of families who rely solely on women’s wages to survive.  The impact of this inequality increases over the years, as women experience poverty and personal wage deficits that extend to individual savings, pensions, unemployment benefits and even Social Security.

NASW will continue to advocate for women’s economic security and fairness in the workplace by seeking enactment of the Paycheck Fairness Act.  The Association urges Congress to support the efforts of Social Workers as we advance public policies that alleviate intolerance and promote equality for all.

Take Action Today!

Action Requested

Contact your Representative today about signing on as a cosponsor to H.R. 5040, the “HIT Extension for Behavioral Health Services Act.”

Background

Rep. Patrick Kennedy (D-RI) has introduced bi-partisan legislation along with Rep. Tim Murphy (R-PA), a clinical psychologist, called the Health Information Technology Extension for Behavioral Health Services Act of 2010 (H.R. 5040). The bill, introduced on April 15, 2010, would extend the new Medicare and Medicaid “meaningful use” incentive payments established under the HITECH Act within the American Recovery and Reinvestment Act (ARRA) to clinical social workers and other mental health and substance abuse providers and facilities.

ARRA provides $20 billion in incentives and grants to health care providers and hospitals to establish interoperable electronic health record (EHR) systems throughout the nation. Medicare and Medicaid ARRA payment incentives are available to most physicians, chiropractors, dentists, optometrists, podiatrists and hospitals.  However, Congress excluded from eligibility behavioral health providers, as well as most non-physician practitioners, because of cost concerns when the law was enacted in 2009. Among those providers who would be eligible for the payments under Rep. Kennedy’s H.R. 5040 are clinical social workers, clinical psychologists, psychiatric hospitals, substance use treatment facilities and mental health treatment facilities.

As enacted, ARRA establishes a vast national EHR system that excludes the electronic patient records of clinical social workers’ and other behavioral health providers. If the current law’s deficiency is not corrected, the behavioral health records of many consumers will likely remain in paper form and therefore less accessible to other health care providers. Nevertheless, there is a high risk that excluded providers would be compelled to use electronic health records systems to participate within commercial provider networks and to obtain EHR information from covered physicians and facilities. NASW is a supporter of strong patient privacy protections established within ARRA, and also believes that quality of care will likely be seriously compromised if the records of clinical social workers and other behavioral health providers remain excluded from developing EHR systems.

Details on H.R. 5040

NASW believes it is essential to integrate care delivered by clinical social workers with other behavioral health and medical providers, and this legislation will be an important priority for enactment. The Health Information Technology Extension for Behavioral Health Services Act would:

• Clarify the definition “health care provider” throughout the HITECH/ARRA Act to include clinical social workers and psychologists, substance abuse professionals, psychiatric hospital, behavioral and mental health clinics, and substance use treatment facilities.
• Establish grants for those mental health treatment facilities not eligible for meaningful use incentives through the HITECH/ARRA Act. The grants allow for purchasing certified EHRs, training medical staff in the use of EHRs, and improving the exchange of health information between mental health providers and other health care providers.

Extend Medicare and Medicaid payment incentives for meaningful use of EHRs to clinical social workers and psychologists, psychiatric hospitals, mental health treatment facilities, and substance abuse treatment facilities.

On March 30, 2010, President Obama signed into law the Health Care and Education Affordability Reconciliation Act (H.R. 4872). NASW strongly supported this bill and has tirelessly advocated for the creation of public policies that make health care and higher education more affordable and accessible for all Americans. The higher education provisions are expected to generate significant savings by redirecting lender subsidies to boost Pell Grant scholarships, expand the Income Based Repayment Program, increase the number of students who enter and complete college, including community colleges, and invest over $2 billion in Historically Black Colleges and Universities (HBCU) and minority serving institutions (MSI) to provide students with the support they need to stay in school. The bill passed the House and Senate on March 25 with a Democratic vote of 220-207 and 56 to 43, respectively.

While some colleges and universities have already switched to direct lending, others are racing to switch from private lenders to the U.S. Department of Education by July 1, 2010. The lending overhaul, which would eliminate a program that subsidizes banks and other providers of federally backed loans, is projected to save the federal government $61 billion over 10 years with more than half of the savings channeled to Pell grants for low income students. More than 8 million low income students rely on these grants to fund their education.

For more information about our advocacy efforts to make higher education more affordable go to www.socialworkers.org/loanforgivness

To join the Advocacy listserv, go to http://capwiz.com/socialworkers/mlm/verify/

On March 17, 2010, Education Secretary Arne Duncan testified before the House Education and Labor Committee on the Obama Administration’s newly released blueprint for revamping the Elementary and Secondary Education Act (ESEA), currently known as the No Child Left Behind Act. He focused on the themes of college and career readiness, accountability for all students, and incentives for states to improve their approach to educating our nation’s students. The Committee expressed a strong commitment to working with the Administration in rewriting the law. In his opening statement, Chairman George Miller said “the President’s blueprint lays important markers for us as we begin this rewrite.” To view the full statement click here http://edlabor.house.gov/hearings/full-committee/

NASW, independently and in collaboration with the National Alliance of Pupil Serving Organizations (NAPSO), recently submitted comments for the Chairman to consider as Congress gears up to reauthorize the No Child Left Behind Act https://www.socialworkers.org/advocacy/issues/education/default.asp

• For information on joining NASW’s Advocacy listserv, go to http://capwiz.com/socialworkers/mlm/verify/.
• For more information on the School Social Work Specialist credential, go to http://www.socialworkers.org/credentials/default.asp.
• For more information on the school social work specialty practice section, go to http://www.socialworkers.org/credentials/default.asp
• For more information on school social work practice, including practice standards, go to http://www.socialworkers.org/practice/default.asp.
• For information on books and research regarding school social work practice, go to www.naswpress.org

The House Education and Labor Subcommittee on Early Childhood, Elementary and Secondary Education held a hearing on March 18, 2010 titled “Elementary and Secondary Education Act Reauthorization: Addressing the Needs of Diverse Students” to examine how schools can appropriately educate low-income, minority, English Language Learners, disabled, Native American, and homeless students within the context of reauthorizing  the Elementary and Secondary Education Act (ESEA), currently known as the No Child Left Behind Act.

This goal was expressed by Subcommittee Chairman Representative Dale Kildee (D-MI) in his opening statement: “While the No Child Left Behind Act shed light on the inequalities in our education system, it unfortunately did not do enough to close the achievement gap for diverse students…This must be a top priority for future steps in education reform.”

To this end, the Subcommittee considered recommendations from a panel of educators, advocates, and a researcher working to close the achievement gap for diverse students. They included Dr. Daniel Curry, Superintendent for the Lake Forest School District in Felton, Delaware, Dr. Jack Dale, Superintendent for Fairfax County Public Schools in Falls Church, Virginia, Arelis Diaz, Assistant Superintendent for Godwin Heights Public Schools in Wyoming, Michigan, Dr. David Gipp, President of United Tribes Technical College (UTTC), Jacqui Farmer Kearns, Principal Investigator for the National Alternate Assessment Center, and Michael Wotorson, Executive Director of Campaign for High School Equity.

To read the transcript go tohttp://edlabor.house.gov/hearings/ecese/

Go here for more information on NASW’s advocacy efforts. 
Join the Advocacy Listserv to receive regular updates
NASW Standards for Social Work in Schools 
NASW Specialty Practice Section for School Social Work 
NASW School Social Specialist Credential

“We cannot accept ongoing marginalization of half the world’s population”
- Sec. Hillary Clinton

Jan 8, 4pm – Secretary of State Hillary Rodham Clinton just completed a major speech commemorating the 15th anniversary of the International Conference on Population and Development (ICPD) in support of women’s rights to reproductive health and family planning. Secretary Clinton highlighted the importance of ensuring women’s access to reproductive health and family planning services and helping women and girls lead healthy, productive and fulfilling lives.  She also emphasized that we must advocate for equity on behalf of women and girls and that they should, and will, be a central part of the United States foreign policy.   View the speech at www.icpd2015.org

Dear Colleague,

I am writing to ask you, and every single NASW member, to contact your members of Congress and show your full support for the Dorothy I. Height and Whitney M. Young, Jr. Social Work Reinvestment Act (H.R. 795/ S.686) . This is the first piece of federal legislation ever introduced that will directly address the workforce challenges that our profession is facing. These challenges, such as low salaries, high educational debt, and serious safety concerns are making it difficult to assist the 10 million clients that social workers across the country serve each day. Take a moment to view this CNNmoney.com study, which rates social work at the top of the list of stressful jobs that pay badly. Rep. Towns recently discussed this study in a “Dear Colleague” he sent to his fellow members of Congress asking for their support for H.R. 795.

The Dorothy I. Height and Whitney M. Young, Jr. Social Work Reinvestment Act is designed to address the workforce challenges we are facing, thereby helping to ensure that millions of individuals and families throughout the nation can continue to receive competent social work care.  The legislation will establish a Social Work Reinvestment Commission to provide a comprehensive analysis of current workforce trends and develop long-term recommendations and strategies to ensure an adequate social work workforce.  In addition, demonstration programs will award grants in the areas of workplace improvements, research, education, training, and community-based programs of excellence.

We also want to thank social workers, Representative Towns and Senator Mikulski, for introducing this legislation and for their consistent dedication and leadership of the social work profession.  We hope you will take a moment to thank them too. You can print this postcard and mail it to Senator Mikulski and Representative Towns or you can send them a quick thank you email. (View Senator Mikulski’s and Representative Towns’ contact information.) It’s important to remember and thank our social work advocates in Congress!

As always, we appreciate your advocacy and leadership on the issues that are important to our profession.

Sincerely,

Executive Director
Elizabeth J. Clark, PhD, ACSW, MPH

Because Congress will be in recess for the Thanksgiving holiday, there will be no Health Care Roundup on Tuesday, December 1. The next publication will be on Tuesday, December 8.

Rally on Reproductive Choice in Health Care Reform

The U.S. House of Representatives passed an amendment to the health care reform legislation sponsored by Bart Stupak (MI-1) and Joe Pitts (PA-16). This amendment would restrict access to abortion procedures for consumers who receive subsidies to buy insurance in a reconfigured health care system. Pro-choice organizations are very concerned the new language threatens the availability of private insurance coverage for comprehensive reproductive health care services.

NASW is co-sponsoring a rally and lobby day on Wednesday, December 2. The day starts at 9am with a lobby training followed by a briefing from 9:30 – 10:30am. Lobby visits from 10:30-11:30.  There will be an event from 12:00-2:00 and more lobby visits from 2:00-4:30.  Events will take place in the Dirksen Auditorium G-50. A wrap up will take place at 4:30 in Rayburn Banquet Room B369. If you would like to participate in the lobby day, please contact Dina Kastner at advocacy@naswdc.org (the mailbox is now accepting messages) so she can set up appointments for you.

Senate Opens Floor Debate on Health Reform

On Saturday, November 21 the U.S. Senate agreed to hold debate on health reform legislation known as the “Patient Protection and Affordable Care Act,” (H.R. 3590). The bill is expected to be on the floor for several weeks after Thanksgiving and will require significant changes to clear the filibuster hurdle of 60 votes to secure passage. NASW plans to strongly support passage, but will also support changes in the bill including those that improve coverage and protect against any weakening amendments of women’s rights to reproductive choices. NASW expects to be very actively involved in this debate; members wishing to keep up to date on our activities should visit our health reform webpage here.

Financial Impact of Health Reform

There is a great deal of analysis available on health reform legislation, but information from non-partisan congressional sources, such as the Congressional Budget Office, is frequently most pertinent to legislative decision making. Readers interested in learning more about the impact of health care reform legislation on federal spending may wish to view congressional analyses of the legislation.  These two inks summarize the budgetary impact of the House bill, HR. 3962: Health Care by the Numbers and Controlling Health Care Costs.

The Senate bill the “Patient Protection and Affordable Care Act,” (H.R. 3590) is still new so nonpartisan analyses of its budgetary impact are still becoming available. One summary is linked here and more information appears here. A brief comparison of the Senate and House versions of health reform legislation is available by this link to a Washington Post interactive site.

HHS Secretary Kathleen Sebelius on Monday announced the release of Health Insurance Reform: The Case for Change, a series of state-by-state reports highlighting the benefits of health insurance reform. The reports are available now here.

Medicare Fee Fix Passes House Floor Moves to Senate

The House passed legislation H.R. 3961 on November 19, which would prevent a scheduled 21 percent cut in Medicare doctors’ payment rates, although its fate remains uncertain. Without congressional action, payment rates for Medicare physician and clinical social worker services will drop by 21 percent on January 1, 2010. The prospect of steep payment cuts has raised fears that care to beneficiaries could be disrupted. The fate of corrective legislation that would permanently repeal the flawed sustainable growth rate (SGR) formula that determines future payment rates in Medicare and TRICARE remains uncertain. The SGR formula is frequently inappropriately described as the Medicare “physician fee” formula, but it actually sets the overall rate of increase or decrease for all Medicare Part B independent practitioners, including clinical social workers. NASW supports corrective legislation that would halt scheduled cuts in Medicare payments to clinical social workers and other health professionals and has urged Congress to adopt a plan to recalibrate how those payments are set each year. See NASW’s letter to Congress here.

Correcting the problem before the rate cuts go into effect on Jan. 1, will be politically extremely difficult. The Senate’s huge health care reform bill (H.R. 3590) includes short-term Medicare rate relief, but this provision is highly controversial and may change during floor consideration. Currently, the Senate plans to return to its physician payment bill once they finish work on health care reform, likely meaning it won’t be considered until sometime after the cuts go into effect on Jan. 1. Congress in the past has occasionally failed to enact the physician payment legislation in time, but has simply later passed retroactive legislation that restores the payment rates. Current law requires even further reductions in Medicare physician fees, a loss which will total to a 40 percent cut by 2016. If the Senate agrees to separate physician payment legislation, it may simply approve the House passed bill, but for now, a politically acceptable solution has not been identified.

Health Technology Loan Measure Passed by House

On November 18, the House passed, by voice vote, a bill (HR 3014) creating a new program to be administered by the Small Business Administration that would guarantee small business loans to health professionals such as clinical social workers and physicians to obtain health information technology for use in small or independent health practices. Eligible health information technology includes computer hardware, software, and related technology that supports the meaningful electronic health record use requirements of Medicare and purchased by an eligible professional to aid in the provision of health care, including electronic medical records. Information technology whose sole use is financial management, maintenance of inventory of basic supplies, or appointment scheduling would not qualify for the loan program. The legislation has been referred to the Senate where action is uncertain at this time.

GINA Employment Provisions Take Effect

On November 21, the Genetic Information Nondiscrimination Act (GINA) took effect for all employers with 15 or more employees and it took effect for individual health insurance plans last May.

GINA was passed by Congress last year and prohibits the use by employers of genetic or family medical history in making hiring, firing, promotion or job placement decisions.  Employers cannot require employees to undergo a genetic screening or ask employees for such medical information.

In related news, NASW joined various groups on a letter to the Department of Labor, Department of Health and Human Services and the Internal Revenue Service stating our opposition to any delay or weakening of the GINA regulations.  The letter states, “any delay in implementation would continue to allow employers to inquire about employees’ private genetic information or their families’ medical history, while penalizing employees who choose to keep that information private; any such exemption would create a loophole to significantly weaken the protections afforded to employees and the American people under GINA”.

On November 21, the Genetic Information Nondiscrimination Act (GINA) took effect for all employers with 15 or more employees and it took effect for individual health insurance plans last May.

GINA was passed by Congress last year and prohibits the use by employers of genetic or family medical history in making hiring, firing, promotion or job placement decisions. Employers cannot require employees to undergo a genetic screening or ask employees for such medical information.

In related news, NASW joined various groups on a letter to the Department of Labor, Department of Health and Human Services and the Internal Revenue Service stating our opposition to any delay or weakening of the GINA regulations. The letter states, “any delay in implementation would continue to allow employers to inquire about employees’ private genetic information or their families’ medical history, while penalizing employees who choose to keep that information private; any such exemption would create a loophole to significantly weaken the protections afforded to employees and the American people under GINA”.